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Permit Electrical 2013-9-11
SPRINGFIELD _. 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 : Phone: 541-726-3753 OREGON Building /Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02045 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/11/2013 EXPIRES: 03/10/2014 STATUS DATE: 09/11/2013 APPLIED: 09/11/2013 . SITE ADDRESS: 216 S 52ND PL,Springfield,OR 97478 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702333401700 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace Service OWNER: JENNINGS JOSEPH D&PATEL APEKSHA M Phone Number: ADDRESS: 878 OSPREY LOOP ' CRESWELL OR 97426 - CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor JENNINGS ELECTRICAL SERVICES LLC COB 200127 06/05/2015 541-997-4504 INSPECTIONS REQUIRED Inspections 4220 Electrical-Service . 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical work is complete. By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time,that each address is readable from the street, that the permit card is located at the front of the property,and the approved set of plans will remain on the site at all times during construction. '/�� 9h//20/7 Owner or Contractor Signature Date • ATTENTION: Oregon law requires you Utility follow rules adopted by the Oregon les are NOTICE: Notification Center. Those r through OAR 9 et 001h THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952 001 obtain cops of the rules by . AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone number for the Oregon Utility Notification NY 180 DAY PERIOD. Center is 1-800-332-2344). • Springfield Building'Permit 9/11/2013 12:53:40PM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD 225 Fifth St *el OREGON TRANSACTION RECEIPT Springfieltl•OR97477 541-726-3753 811-SPR2013-02045 www.springfield-or.gov 216 S 52ND PL permitcentercgspdngfield-or.gov RECEIPT NO: 2013002008 RECORD NO:811SPR2013-02045 DATE:09/11/2013 jol�cfe�;11AA[ol s. -+_� 1� .? a...-.y.�; •' _ . .:_. zeACCOUNT.GODE/TRANS.CODE,3? _`�'.�' :- T5 Services 200 amps or less 224-00000-426102 1004 89.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 1088 r - Technology fee(5%of permit total) 100-00000-425605 2099 4.45 TOTAL DUE: 104.13 IC PAYMENTOTiYP,E PAYOrSTEASRIER:JLARSON COMMENTS NIOU.KIR Credit Card JENNINGS ELECTRICAL SERVICES I 104.13 125 TOTAL PAID: 104.13 Electrical Permit Application DEPARTMENT USE ONLY SPFMGFlEL� +.wr.n.ey J eITVO SPRINGFIEL3D'TOREG9N± i ' ,e l4 -i t` ' ;.t.r.,..°G .ene- 7,41 d`e_ft :,#_-.. 4 Permit no Of I Or( 3 (��L(S ., t 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 ////� . Date: This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. :;:}t a, LOCAL„GOVERNMENT3APPROYAG i A "."„ :-,`,e r ,'`ti'{'{ 2REE=SCHEDULE_Wa i f, aW,; e approval ❑ ❑ No Number of spectton per item ON Qty " ,eassT k cost'}` Zoning a roval verified? Yes - e. *i ,w uaCATEGORY,SOF,'s,CONSTRUCT ION, y%?°`M-it..n.?�.. ''N. Residential,per unit,service included: ❑ Residential ❑Government ❑ Commercial 1,000 sq.ft.or less(4) $147.50 $ 00.3 JOB=SITE INF013MATIONANpD LOCATION Maki 2I� � Sz / L- Each additional 500 sq.ft.or portion $ 27.50 $ Job site address: thereof City: SPrti(e���p IC State: ZIP: Limited energy(2) $ 35.00 $ Reference: Taxlot Each manufactured home or modular $ 69.00 $ ii!*02,:r4MDESC RIPTION10F.S-WORK a "XS'i `r t rw" „ dwelling service or feeder(2) IS.e_r IcC 2K e 1 1-- b-i✓ C/C r'cw' 1.l t_.� Services or feeders: installation, alteration,relocation 1 200 amps or less(2) / $ 89.00 $ n g.0' `2P..ROPERTY OUIINERr F; "d- M03 201 to 400 amps(2) $ 104.50 $ Name: An + 1 401 to 600 amps(2) $174.00 $ cepL �A1�� �`�� Address: u 601 to 1,000 amps(2) $225.50 $ Ci It State: (t� ZIP: Over 1,000 amps or volts(2) $516.00 $ ty: C��.st�� Phone: - - Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family. This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479.5400) and 479.5600). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above a Igil v5lq CONTRACT,OR;IINSTALL fAT•,ION" t„�1'hyn`('! '/Ir3;'' Branch circuits: new alteration, extension per panel Business name:,,Jl,A\ vtcp E cI_c_Sri Cn' �J,cos L.7-C, a. Fee for branch circuits with purchase of a service or feeder fee: Address: 7c 31-14/ osi, (OC(C c1!-rCC-J Each branch circuit $ 6.50 $ City: ffD'n'Pvlc' o_N State: ZIP: 9 74/37 b.Fee for branch circuits without purchase of a service or feeder fee: Phone:9% X17,C/501 Fax: - - First branch circuit(2) $ 60.50 $ 11__ , E-mail: 4(I Ow.w S , ,]st vi el`n.,^, s „._2 Ck. it<c 0. ,C Each additional branch circuit $ 6.50 $ CCB license no.: ZDp 12.7 ti CD license no.: C 776 Miscellaneous fees:service or feeder not included Signing supervisor's license no.: j-7/ © S'" Each pump or irrigation circle(2) $ 69.00 $ -r Print name of signing supervisor: 4a„,4S' ywt .,7 S Each sign or outline lighting(2) $ 69.00 $ Signature of signing supervisor: Signal circuit or alimited-energy panel, $ 80.00 $ alteration,or extension(2) Each additional inspection:(1) $80.00 $ 3:1: 7.4,'+. x&J.'?a `APPLICANT.°USE `.K-'MW ;,l (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ (B)Enter 12%surcharge(.12 x[A]) - $ (C)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through C): $/(217/.2- 440-25844(4/012013/COM)